Specialist, Data (PACE)

Data Specialist will collect, analyze, and report data to evaluate PACE participants' demographic, eligibility verification, claim management, encounter processing, and data integrity. Interact directly with the Center of Medicare and Medicaid Services (CMS) and California Department of Health Care Services (DHCS) to submit required data and mitigate complex data issues to ensure proper revenue flow impacting AltaMed's financial performance. This position must be able to make determinations and present business conclusions based on data analysis, identify and monitor key service metrics that may affect service quality, member retention, and patient utilization. Understand standard operating procedures of AltaMed's internal processes, audit practices, and keep up to date with various State and Federal regulations impacting PACE organizations. Collaborate with various supporting organizations, National PACE Association, outside vendors, and contract managers to implement and enhance patient satisfaction, ensuring multiple software that are in sync with AltaMed PACE systems. Work with other data analysts within AltaMed to consolidate reports and analyze data to guide management and Senior Leadership in making operational, tactical, and strategic decisions.

Responsibilities

Collect, analyze, and report data to evaluate PACE participants' demographic, eligibility verification, claim management, encounter processing, and data integrity; Interact directly with the Center of Medicare and Medicaid Services (CMS) and California Department of Health Care Services (DHCS) to submit required data and mitigate complex data issues to ensure proper revenue flow impacting AltaMed's financial performance; Make determinations and present business conclusions based on data analysis; Identify and monitor key service metrics that may affect service quality, member retention, and patient utilization; Understand standard operating procedures of AltaMed's internal processes and audit practices, and keep up to date with State and Federal regulations impacting PACE organizations; Collaborate with National PACE Association, outside vendors, and contract managers to implement and enhance patient satisfaction, ensuring multiple software are in sync with AltaMed PACE systems; Work with other data analysts to consolidate reports and analyze data to guide management and Senior Leadership in operational, tactical, and strategic decisions

Requirements

High School diploma or equivalent work experience; Minimum of 2 years of experience working with CMS, DHCS, or other professional office environments in the health care industry; Minimum of 2 years of working experience using Microsoft Access and Excel

Nice to have

Bachelor's degree preferred; Bilingual Spanish/Chinese preferred

Benefits

Medical, Dental and Vision insurance; 403(b) Retirement savings plans with employer matching contributions; Flexible Spending Accounts; Commuter Flexible Spending; Career Advancement & Development opportunities; Paid Time Off & Holidays; Paid CME Days; Malpractice insurance and tail coverage; Tuition Reimbursement Program; Corporate Employee Discounts; Employee Referral Bonus Program; Pet Care Insurance